2017-01-01 12:00 - Messages

Joint association of multimorbidity and work ability with risk of long-term sickness absence

A prospective cohort study with register follow-up
Objectives: The aim of this study was to determine the joint association of multimorbidity and work ability with the risk of long-term sickness absence (LTSA) in the general working population.
Methods: Cox regression analysis censoring for competing events (statutory retirement, early retirement, disability pension, immigration, or death) was performed to estimate the joint association of chronic diseases and work ability in relation to physical and mental demands of the job with the prospective risk for LTSA (defined as ≥6 consecutive weeks during 2-year follow-up) among 10 427 wage earners from the general working population (2010 Danish Work Environment Cohort Study). Control variables were age, gender, psychosocial work environment, smoking, leisure physical activity, body mass index, job group, and previous LTSA.
Results: Of the 10 427 respondents, 56.8% had experienced ≥1 chronic disease at baseline. The fully adjusted model showed an association between number of chronic diseases and risk of LTSA. This association was stronger among employees with poor work ability (either physical or mental). Compared to employees with no diseases and good physical work ability, the risk estimate for LTSA was 1.95 [95% confidence interval (95% CI) 1.50–2.52] for employees with ≥3 chronic diseases and good physical work ability, whereas it was 3.60 (95% CI 2.50–5.19) for those with ≥3 chronic diseases and poor physical work ability. Overall, the joint association of chronic disease and work ability with LTSA appears to be additive.
Conclusions: Poor work ability combined with ≥1 chronic diseases is associated with high risk of long-term sickness absence in the general working population. Initiatives to improve or maintain work ability should be highly prioritized to secure sustainable employability among workers with ≥1 chronic diseases.p>

Source: Sundstrup, E., Jakobsen, M. D., Mortensen, O. S., & Andersen, L. L. (2017). Scandinavian Journal of Work, Environment & Health.
http://dx.doi.org/10.5271/sjweh.3620

Troubles musculosquelettiques

Revue réaliste sur les bases théoriques des programmes de réadaptation incluant le milieu de travail
Une revue réaliste portant sur un ensemble de programmes de réadaptation au travail incluant une intervention en milieu de travail a été réalisée. Selon cette méthode, les programmes se caractérisent par trois éléments principaux : le contexte (C), qui représente les caractéristiques des conditions dans lesquelles les programmes sont mis en place et les composantes de ces derniers; les mécanismes (M), qui décrivent ce qui fait en sorte qu'un programme parvient à atteindre ses résultats; et les résultats (O, pour outcomes), soit les effets prévus et imprévus d'un programme, résultant de l'interaction de différents mécanismes, dans différents contextes.

Source: http://www.irsst.qc.ca/publications-et-outils/publication/i/100905/n/troubles-musculosquelettiques-bases-programmes-readaptation

Effectiveness of Occupational Therapy Interventions for Adults With Musculoskeletal Conditions of the Forearm, Wrist, and Hand

A Systematic Review
Occupational therapy practitioners are key health care providers for people with musculoskeletal disorders of the distal upper extremity. It is imperative that practitioners understand the most effective and efficient means for remediating impairments and supporting clients in progressing to independence in purposeful occupations. This systematic review provides an update to a previous review by summarizing articles published between 2006 and July 2014 related to the focused question, What is the evidence for the effect of occupational therapy interventions on functional outcomes for adults with musculoskeletal disorders of the forearm, wrist, and hand? A total of 59 articles were reviewed. Evidence for interventions was synthesized by condition within bone, joint, and general hand disorders; peripheral nerve disorders; and tendon disorders. The strongest evidence supports postsurgical early active motion protocols and splinting for various conditions. Very few studies have examined occupation-based interventions. Implications for occupational therapy practice and research are provided.

Source: Roll, S. C., & Hardison, M. E. (2017). American Journal of Occupational Therapy, 71(1).
https://dx.doi.org/10.5014%2Fajot.2017.023234

Factors Associated With Success in an Occupational Rehabilitation Program for Work-Related Musculoskeletal Disorders

Work-related musculoskeletal disorders are a significant burden; however, no consensus has been reached on how to maximize occupational rehabilitation programs for people with these disorders, and the impact of simulating work tasks as a mode of intervention has not been well examined. In this retrospective cohort study, the authors used logistic regression to identify client and program factors predicting success for 95 clients in a general occupational rehabilitation program and 71 clients in a comprehensive occupational rehabilitation program. The final predictive model for general rehabilitation included gender, number of sessions completed, and performance of work simulation activities. Maximum hours per session was the only significant predictor of success in the comprehensive rehabilitation program. This study identifies new factors associated with success in occupational rehabilitation, specifically highlighting the importance of intensity (i.e., session length and number of sessions) of therapy and occupation-based activities for this population.

Source: Hardison, M. E., & Roll, S. C. (2017). American Journal of Occupational Therapy, 71(1).
https://dx.doi.org/10.5014%2Fajot.2016.023200

An Intervention Bundle to Facilitate Return to Work for Burn-Injured Workers

Report From a Burn Model System Investigation
Rates of return to work (RTW) after burn injury vary. A 2012 systematic review of the burn literature reported that nearly 28% of all adult burn survivors never return to any form of employment. These authors called for interventions designed to assist survivors' ability to function in an employed capacity. In 2010, our burn center outpatient clinic instituted an intervention aimed to return injured workers to employment within 90 days of their insurance claims. The interventions include patient/family education focused on recovery rather than disability, employer contact and education by the vocational rehabilitation (VR) counselor, physician recommendations for work accommodations, provision of employee status letters, and Activity Prescription Forms (APFs). The purpose of this study is to report on the effectiveness of these interventions. Following institutional review board (IRB) approval, medical records of adults with occupation-related burn injuries and receiving care at a single regional burn center from June 2010 to July 2015 were reviewed. Data on patient and injury characteristics and outpatient VR services provided were collected. The primary outcome of interest was the percentage of patients who RTW; 338 individuals met study entry criteria. The VR counselor evaluated all patients. All patients received an employer letter(s) and APF documentation. Workplace accommodations were provided to more than 30% of patients. RTW rate was 93%, with an average of 24 days from injury to RTW. In an intervention bundle involving the patient, employer, Workers' compensation, and the burn clinic staff, injured workers achieved a high rate of RTW. Although we cannot correlate individual bundle components to outcome, we postulate that the combination of employer/employee/insurer engagement and flexibility contributed to the success of this program.

Source: Carrougher, G. J., Brych, S. B., Pham, T. N., Mandell, S. P., & Gibran, N. S. (2017). Journal of Burn Care & Research, 38(1), e70-e78.
http://dx.doi.org/10.1097/BCR.0000000000000410

The role of health-care providers in the workers' compensation system and the return-to-work process

International research has generated strong evidence that health-care providers have a key role in the return-to-work (RTW) process. However, pressure on consultation time, administrative challenges and limited knowledge about a patient's workplace can thwart meaningful engagement. This multi-jurisdictional, two-year study focused on health-care providers' experiences within the workers' compensation system and their role in the RTW process.

Source: http://www.iwh.on.ca/system/files/documents/role_of_health-care_providers_in_return_to_work_final_report_2016.pdf

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